Examination of function and structure of respiratory cilia of adult patients suffering from chronic obstructive pulmonary disease (COPD) – comparison of nasal and bronchial mucosa (pilot of CILIARY STUDY)

Czech version

Authors: V. Koblížek ¹; T. Dobešová ¹; F. Salajka ¹; Eva Čermáková ²; M. Tomšová ³; D. Pohnětalová ³; P. Papoušek ⁴; V. Bartoš ¹; Z. Paráková ¹; J. Ruta ¹; V. Sedlák ¹
Authors‘ workplace: Plicní klinika Lékařské fakulty UK a FN, přednosta doc. MU Dr. František Salajka, CSc. ¹; Ústav lékařské biofyziky Lékařské fakulty UK Hradec Králové, přednosta doc. Ing. Josef Hanuš, CSc. ²; Fingerlandův ústav patologie Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MU Dr. Aleš Ryška, Ph. D. ³; Ústav patologické fyziologie Lékařské fakulty UK Hradec Králové, přednosta prof. MU Dr. Miroslav Kuba, CSc. ⁴
Published in: Vnitř Lék 2009; 55(11): 1035-1042
Category: Original Contributions

Overview

Introduction:
Borderline between upper and lower respiratory tract pathology is probably artificial (bronchial asthma). Also inflammation of bronchial mucosa during chronic obstructive pulmonary disease (COPD) is likely combined with inflammatory involvement of nasal mucosa. Ciliary edge of respiratory epithelium is very important part of mucosa layer. Aim: To investigate and compare nasal and bronchial ciliary beat frequency (CBF), degree of nasal and bronchial ciliary dyskinesia, presence of ciliary akinesia and incidence of spinocellular metaplasia in the both mucosa localities among of stable COPD patients (pts). Method: Nasal and bronchial mucosa were obtained in the course of bronchoscopy examination of COPD pts in general intravenous anesthesia. Native samples of mucosa tissue were assessed by digital high‑speed video microscopy (1,000× magnification). Paired t‑test was used to evaluate differences in average frequencies. Significance level was α = 0.05. Mode was used to describe „index of dyskinesia“, as a measure of association was used κ coefficient. Material: Seventeen COPD pts (6 weeks free of exacerbation) at the age 47– 80 (average 64.2 years ± 9,7) were examined (13 male), average FEV₁ 61% predic. value (21– 81, ± 15). All patients were active smokers (average 42 pack years ± 22.8) and all suffered from bronchitic (daily sputum production) phenotype of COPD. Results: We did not find any difference in average ciliary beat frequencies between nose (6,0 Hz ± 1.3) and bronchus (5.9 ± 1.3) locality (p = 0.427). We find weak association between nose and bronchus in „ciliary akinesia“ (κ = 0.282) but medium association in „metaplasia“ (κ = 0.485), in index of dyskinesia (κ = 0.733). Conclusion: We did not find in our data any difference in nasal and bronchial ciliary beat frequencies and we found medium association between nasal and bronchial spinocellular metaplasia and index of ciliary dyskinesia. Possible generalization of these results would require further investigation and analysis.

Key words:
nasal mucosa – bronchial mucosa – chronic obstructive pulmonary disease – ciliary study – ciliary beat frequency – ciliary akinesia – spinocellular metaplasia

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